title: How do changes in body mass index in infancy and childhood associate with cardiometabolic profile in adulthood? Findings from the Northern Finland Birth Cohort 1966 Study.
abstract: OBJECTIVE
  Postnatal growth patterns leading to obesity may have adverse influences on future cardiometabolic health. This study evaluated age and body mass index (BMI) at infant BMI peak (BMIP) and childhood BMI rebound (BMIR) in relation to adult cardiometabolic outcomes in the Northern Finland Birth Cohort 1966.
  
  
  METHODS
  BMI at various ages was calculated from frequent height and weight measurements obtained from child health and welfare clinical records. Age and BMI at BMIP and BMIR were derived from random effect models fitted at >0-1.5 years (N=3 265) and >1.5-13 years (N=4 121). Cardiometabolic outcomes were obtained from a clinical examination at age 31 years. Multiple regression models were used to analyse associations between the derived growth parameters and cardiometabolic outcomes.
  
  
  RESULTS
  Age and BMI at BMIP were positively associated with adult BMI and waist circumference (WC), independently of birth weight and infant height growth (P<0.05). Later BMIR was associated with a better cardiometabolic profile: adult BMI and insulin were 14% lower, WC and triglycerides were 10% lower and the odds of metabolic syndrome (MetS) were 74% lower per 2 s.d. (1.86 years) higher age at BMIR (P<0.0001). BMI at rebound had generally weaker associations with cardiometabolic outcomes, which attenuated after adjustment for age at BMIR.
  
  
  CONCLUSIONS
  Age and BMI at infant BMIP were associated with adult adiposity but not with other cardiometabolic outcomes. Earlier timing of BMIR was a risk factor of an adverse cardiometabolic profile, independently of early growth or BMI at rebound. Identifying growth patterns harmful to cardiovascular health will give opportunities for early interventions.
authors.affiliation: 1] Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK [2] Department of Epidemiology and Biostatistics, MRC-HPA Centre, School of Public Health, Imperial College London, Norfolk Place, London, UK.
authors.forename: U
authors.initials: U
authors.lastname: Sovio
authors.affiliation: 1] Institute of Health Sciences, University of Oulu, Oulu, Finland [2] Biocenter Oulu, University of Oulu, Oulu, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Kaakinen
authors.affiliation: 1] Department of Epidemiology and Biostatistics, MRC-HPA Centre, School of Public Health, Imperial College London, Norfolk Place, London, UK [2] Department of Hygiene and Epidemiology, Medical School University of Ioannina, Ioannina, Greece.
authors.forename: I
authors.initials: I
authors.lastname: Tzoulaki
authors.affiliation: Department of Epidemiology and Biostatistics, MRC-HPA Centre, School of Public Health, Imperial College London, Norfolk Place, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Das
authors.affiliation: Institute of Diagnostics, Clinical Chemistry, University of Oulu, Oulu, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Ruokonen
authors.affiliation: 1] Department of Children, Young People and Families, National Institute for Health and Welfare, Oulu, Finland [2] Department of Clinical Sciences/Obstetrics and Gynecology, University of Oulu, Oulu, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Pouta
authors.affiliation: Department of Clinical Sciences/Obstetrics and Gynecology, University of Oulu, Oulu, Finland.
authors.forename: A-L
authors.initials: AL
authors.lastname: Hartikainen
authors.affiliation: 1] Department of Epidemiology and Biostatistics, MRC-HPA Centre, School of Public Health, Imperial College London, Norfolk Place, London, UK [2] College of Public Health & Human Sciences, Oregon State University, Corvallis, OR, USA.
authors.forename: J
authors.initials: J
authors.lastname: Molitor
authors.affiliation: 1] Department of Epidemiology and Biostatistics, MRC-HPA Centre, School of Public Health, Imperial College London, Norfolk Place, London, UK [2] Institute of Health Sciences, University of Oulu, Oulu, Finland [3] Biocenter Oulu, University of Oulu, Oulu, Finland [4] Department of Children, Young People and Families, National Institute for Health and Welfare, Oulu, Finland.
authors.forename: M-R
authors.initials: MR
authors.lastname: Järvelin
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D001823:Body Composition; D015992:Body Mass Index; D049628:Body Size; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004032:Diet; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000517:prevention & control; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055105:Waist Circumference